Korean Journal of Pediatrics 2008;51(1):78-83.
Published online January 15, 2008.
Outcome after relapse in childhood and adolescent osteosarcoma : single institution experience in Korea
Yun-Jeong Lee1, Hyun-Jae Lee1, Dong-Ho Kim1, Jung-Sub Lim1, Jun-Ha Lee1, Kyung-Duk Park1, Dae-Geun Jeon2, Soo-Yong Lee2
1Department of Pediatrics, Korean Cancer Center Hospital, Seoul, Korea
2Department of Orthopedics, Korean Cancer Center Hospital, Seoul, Korea
소아 청소년 골육종 재발 후 치료성적 : 한국의 단일기관 성적
이윤정1, 이현재1, 김동호1, 임중섭1, 이준아1, 박경덕1, 전대근2, 이수용2
1원자력병원 소아청소과
2원자력병원 정형외과
Correspondence: 
Kyung-Duk Park, Email: kd4kid@Kcch.re.kr
Abstract
Purpose
: Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. Although survival rate of osteosarcoma patients has markedly improved, about 20-30% of patients still have a relapse. This study was aimed to find factors that influence postrelapse survival of osteosarcoma in childhood and adolescents.
Methods
: Between 1985 and 2004, of 461 patients who were diagnosed and treated as osteosarcoma in Korean Cancer Center Hospital, 180 patients with recurrent osteosarcoma were retrospectively reviewed. We examined survival rates and analyzed prognostic factors, such as relapse site, post-relapse treatment methods, pathologic response to neoadjuvnat chemotherapy, metastasis at first diagnosis, and relapse free interval.
Results
: The overall recurrence rate of patients with osteosarcoma was 39%. The 5-year and 10-year postrelapse survival rates in the recurrent osteosarcoma were 13% and 4%, respectively. The 5-year post-relapse survival rate was influenced by site of relapse (lung, 39%; local, 0%; lung & bone, 25%; others, 12%; P<0.05), relapse-free interval (<12 months, 13%; ≥12 months, 44%, P<0.05), and post- relapse treatment methods (with surgery, 38%; without surgery, 11%; P<0.05).
Conclusion
: The survival rate of recurrent case is very low after 10 years, so new second-line chemotherapy and active treatment is needed to increase survival. Aggressive surgery with the removal of recurrence sites combined with multi-agent chemotherapy could either cure patients with recurrent osteosarcoma or significantly prolong their survival.
Key Words: Osteosarcoma, Recurrence, Survival rate


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